This op-ed was originally published in Pakistan Today on 14 June 2023.
Pakistan’s healthcare system is overburdened and structurally misaligned, and the country’s rapidly urbanising population is paying the price. Dr. Mohey-ud-din opens with a diagnostic of the system’s core failing: total health expenditure stands at roughly 3 percent of GDP, with the public sector contributing only 1.2 percent. The resulting vacuum is filled by an unregulated private sector, where out-of-pocket (OOP) expenditure exceeds 60 percent of total health spending — a pattern that primarily serves wealthier urban segments while leaving low-income populations exposed to rampant price gouging and inconsistent quality.
The public sector’s own problems compound the crisis. Inadequate funding, crumbling infrastructure, insufficient human resources, poor governance, and weak service delivery all undermine what should be the backbone of primary care. A structural flaw runs through its design: public health infrastructure is organised around administrative boundaries rather than internationally accepted benchmarks such as beds-to-population and doctors-to-population ratios — a mismatch that systematically under-serves high-density urban areas while misallocating resources elsewhere.
The article situates healthcare within Pakistan’s broader security framework, noting that the National Security Policy (NSP) 2022 identifies health security as a core constituent of human security — itself a pillar of economic security — and that COVID-19 elevated health to a national security concern. The NSP reiterates the state’s commitment to addressing quality health facility deficits and calls for investment across preventive, curative, and public health ecosystems.
Dr. Mohey-ud-din argues that targeted reforms and streamlining of urban primary healthcare services can substantially relieve pressure on the system. The piece calls for rationalising public health infrastructure against population-based standards, strengthening preventive care, regulating the private sector, and redesigning service delivery models to reach urban low-income communities — a reimagining grounded in equity rather than administrative convenience.
Read the full article on Pakistan Today: